老年急性髓细胞白血病细胞遗传学及预后分析
投稿时间:2010-10-08  修订日期:2011-03-27  点此下载全文
引用本文:季美华,胡彩华,陶健,陈进,黄泉,马海佳.老年急性髓细胞白血病细胞遗传学及预后分析[J].医学研究杂志,2011,40(5):94-96
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作者单位
季美华 南通大学第二附属医院血液科 
胡彩华 南通大学第二附属医院血液科 
陶健 南通大学第二附属医院血液科 
陈进 南通大学第二附属医院血液科 
黄泉 南通大学第二附属医院血液科 
马海佳 南通大学第二附属医院血液科 
中文摘要:目的分析研究老年急性髓细胞白血病(AML)染色体改变,评价细胞遗传学对老年AML预后的影响。方法采用直接法和培养法制备骨髓细胞染色体,R显带,对34例老年AML患者进行染色体核型分析,观察治疗效果及预后。结果34例中29例染色体检查成功,异常核型检出率58.6%(17/29),正常核型12例。29例AML患者接受正规治疗获完全缓解(CR)17例,部分缓解(PR)5例,未缓解(NR)7例。17例获CR的患者中5例t(15,17),7例正常核型,3例轻度核型异常,2例无分裂相;CR的患者中6例存活超过2年,其中3例t(15,17),2例正常核型,1例15p+。其余2例1个月内死亡,6例在1~2年内死亡,15例在1年内复发死亡。结论老年AML有t(15,17)预后好,而其他核型预后差,大多1~2年内复发死亡。
中文关键词:急性髓细胞白血病  老年  细胞遗传学  预后
 
Cytogenetic Analysis and Prognosis in Acute Myeloid Leukemia Among the Elderly
Abstract:ObjectiveTo analyze the chromosome abnomalities in acute myeloid leukemia among the elderly,and to evaluate the value of cytogenetic analysis which can serve as an effective index for clinical prognosis in AmL among the elderly. MethodsCytogenetic analysis was performed in 34 patients with AML among the elderly.The chromosomes were prepared with direct method and brief culture of cells.The karyotype was detected by conventional cytogenetic R-banding.Clinical diagnosis and prognosis were observed.ResultsCytogenetic analysis was performed successfully in 29 patients. Chromosome abnomalities were identified in 58.6% of AML cases.Chemotherapy was given to 29 cases of AML,of whom,17 cases achieved complete remission,five cases partial remission,7 cases no remission. 5 cases had t(15,17),7 cases had nomal chromosomes and 3 cases had mild abnomal chromosomes among 17 cases of AML which achieved complete remission.Three cases had t(15,17),2 cases had nomal chromosomes,1 case had 15p+ in 6 cases who lived more than 2 years.Two cases were dead in one month,6 cases in one to two years and 15 cases in one year due to relapse.ConclutionThe patients with AML among the elderly with t(15,17) had good prognosis, and the other types had poor prognosis and died in one to two years due to relapse.
keywords:Acute myeloid leukemia  The elderly  Cytogenetics  Prognosis
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